Signs, Symptoms, and Treatments

Kratom is derived from the leaves of a tropical tree (Mitragyna speciosa) that is native to Southeast Asia. It has been used traditionally for centuries as a stimulant in low doses and as a sedative or for pain relief at higher doses. In the U.S., kratom is sold in powder, capsule, and tea form and is commonly marketed as a dietary supplement.

The two primary compounds found in kratom, mitragynine and 7-hydroxymitragynine, interact with opioid receptors, which explains how kratom can relieve pain and calm anxiety. In low doses, kratom can cause stimulant-like effects such as increased energy and alertness; in higher doses, drowsiness, relaxation, and opioid-like effects can occur.[1]

Kratom is not approved for medical use by the FDA.[2] Healthcare professionals and public health agencies have raised concerns regarding the safety of kratom, the potential for abuse, and how there is no regulation of kratom products. The potency and purity of kratom products can vary greatly, which means the effects from kratom products cannot be predicted.

Kratom addiction develops through repetitive exposure, changing the user’s response in the brain. Kratom use activates opioid receptors, causing the user to develop a tolerance and need larger quantities to achieve the same results.[3] Once someone has developed an increased tolerance to kratom, they typically begin to use it more frequently or in higher quantities.

Physical dependence can develop over time, changing a user’s motivation for using kratom for its desired effect to using it to avoid withdrawal and discomfort. The gradual way in which an individual develops a dependence makes it difficult to realize when use has developed into an addiction.

Signs of Kratom Addiction

Common kratom addiction signs may include:

• Expanding kratom tolerance and using larger amounts.
• Strong needs or urges to use kratom.
• Having trouble reducing or stopping use even upon request.
• Using kratom despite experiencing changes in mental or physical health.
• Experiencing withdrawal-type symptoms when use is reduced or stopped.
• Experiencing changes in sleeping habits, moods, and/or daily functions.

By recognizing the signs of kratom addiction, individuals and their support systems can receive the appropriate addiction treatment before the addiction worsens.

When someone who has developed a physical dependence reduces or ends their use, they may experience withdrawal-like symptoms, including irritability, anxiety, muscle pain, inability to sleep, nausea, cravings, and mood changes.[4] 

While the symptoms of kratom withdrawal typically aren’t as severe compared to those of opioid withdrawal, those suffering may find the symptoms uncomfortable enough to continue use. The severity of withdrawal symptoms may differ from person to person based on the dose, duration of use, and their physical health.

Kratom has been shown to have an impact on mental health as well as physical health for people that use it long-term or heavily.[5] Some people develop anxiety, mood swings, or have worsening symptoms of mental health with continued use. Because kratom interacts with the same receptors as opiates in the brain, it can also affect how people respond to stress and their ability to regulate their emotions.

The physical side effects of kratom may include nausea, constipation, tiredness, reduced appetite, and weight loss. Long-term or heavy use may play a role in liver damage or other health issues. Because there are currently no regulations on kratom products, there is a higher likelihood of products being contaminated or having inconsistent doses, and consequently, higher health risks for use.

Kratom is legal at the federal level, but the laws around kratom vary from state to state. In some cases, kratom is banned or restricted in certain states and local areas. With so much variability in the laws governing kratom, many people have the same question: “In which state is kratom illegal?” Currently, kratom is illegal in Alabama, Arkansas, Indiana, Louisiana, Ohio, Vermont, Wisconsin, Rhode Island, and Washington D.C. but it is also banned at the local level in some counties in additional states, including some counties in Florida.[6]

Regulations from Public Health Services such as the U.S. Food and Drug Administration (FDA) and the Drug Enforcement Administration (DEA) have made it clear that they consider kratom a dangerous substance because of the risk of addiction, negative health effects, and lack of quality control.[7] These regulatory issues make it difficult for individuals to assess and understand the risk.

Some people may have used kratom to handle withdrawal symptoms from opiate use. While kratom may provide temporary relief from withdrawal symptoms, it may establish a new addictive pattern of use. This is due to kratom’s effects on the opioid receptors; they create a reinforcement of the same type of pathways used for opiate addiction.

For individuals that have a history of opiate use disorder, using kratom may have a detrimental effect on recovery and increase the risk of relapse or ongoing substance use disorder.[8] Addressing kratom with a structured treatment program can help interrupt this cycle.

Agape Treatment Center is focused on structured, evidence-based outpatient programs that help support both substance use recovery and mental health. Individual treatment plans are based on kratom use, mental health needs, and daily activities. We provide consistent therapeutic support, but not residential or detox services. However, we do provide full-time treatment in the form of our partial hospitalization program, along with intensive outpatient care and standard outpatient treatment.

Agape has incorporated a dual diagnosis approach, which addresses both the kratom addiction and any co-occurring mental health issues such as depression, anxiety, or trauma that often come with it.[9] Treatment plans are designed to support emotional stability and substance use recovery with the understanding of how closely linked these two components are.

We also use a range of holistic and experiential therapeutic practices that support overall wellness in our treatment program. This increases the likelihood of a person developing healthier coping skills, achieving greater emotional regulation, and improving long-term recovery.